Abdominoplasty (tummy tuck)
Abdominoplasty provides a flatter stomach with repaired abdominal muscles and can also be used to sculpt a ‘six pack’. An incision is made across the lower abdomen, then excess skin and fat is removed and the stomach muscles are tightened. The navel is repositioned when the skin is re-stretched over the stomach and a large scar is created across the lower abdomen. A firm strap and drain are worn for a day afterwards, then replaced a compression garment for several weeks. Most patients need three weeks off work.
Liposuction can be used to remove fat from the body or to remove a double chin or jowls, in areas usually unaffected by diets and exercise. Fat is suctioned from localised deposits through small incisions under local anaesthesia. Liposuction can be performed as day surgery and patients usually return to work after three to seven days, though bruising may last for several weeks and swelling for up to two months. The results are permanent.
Phalloplasty, or penis enlargement surgery, can lengthen the penis by up to 5cm and widen it by up to 2cm. With lengthening surgery, a low abdominal incision is made and ligaments are cut at the base of the penis. Fat grafts are taken from the waist or buttocks and are inserted under the skin of the penis to widen it. Patients can take six months to fully recover, though sexual intercourse usually can be resumed after six weeks. The results are permanent.
Nose surgery (rhinoplasty)
Rhinoplasty is used to change the size of the nose, remove a hump, narrow the nostrils, change the angle or refine the tip. The procedure is performed by either the open-structure technique, where the incision is at the base of the nose, or closed, where the incisions are inside the nose. Swelling and bruising subsides within seven to 10 days. Discomfort is minimal and can be treated with over-the-counter painkillers. The results are permanent.
A facelift tightens the skin and the muscles of the face, chin and neck, with results lasting between seven and 10 years. Incisions are made behind the hairline and around the ear, then excess facial fat is removed and the muscles are tightened. Swelling and bruising may last a few weeks and full recovery can take up to three months.
Endoscopic brow lift
A brow lift elevates the tissues of the forehead and brow. With the endoscopic technique, a small telescope is inserted through tiny incisions behind the hairline to act as a guide and to ensure minimal scarring. The small muscles of the forehead that cause frown lines are weakened so they smooth or disappear. The results can last about 10 years, although normal ageing does continue. Swelling and bruising can last up to two weeks and full recovery can take up to six weeks.
Body implants are used to enhance the appearance of the buttocks, biceps, calves, face, pectorals, penis and triceps. They are also used on patients who have had previous surgery, injury or disease. The implant is inserted either above or below the muscle through an incision. They can be used to correct facial imperfections such as sunken cheeks or a receding chin and can improve facial balance when combined with a facelift or eyelid surgery. Cheek implant incisions are made through the hairline or lower eyelids, while the incision for a chin implant is hidden in the mouth.
Implant surgery can create numbness but this usually subsides. Swelling and bruising can result, making talking and eating difficult. Normal activities can usually be resumed after four to seven days, and the results are permanent, unless the implant is surgically removed.
Ear correction (otoplasty)
Otoplasty is used to correct prominent ears. A thin strip of skin is removed behind the ear and the middle cartilage layer is folded back and secured in position for permanent results. The ears are wrapped for a week and are swollen for a few weeks. Normal activities can be resumed in one to two weeks.
Hair restoration surgery involves mini-grafts, micro-grafts and follicular grafts to produce natural-looking thicker hair and reverse baldness. Tiny segments of hair-bearing skin are transferred from the permanent fringe area at the back of the head to the bald area for permanent results. The procedure is performed under local anaesthesia in a series of sessions which take up to three hours, depending on the number of grafts inserted. Some men can return to work the day after treatment.
A thread lift involves textured threads inserted under the skin to lift sagging tissues, particularly in the mid-face and neck. The insertions are made from in the hair with a special needle, under local anaesthetic. The procedure takes about 90 minutes and requires around a week of recovery time. The threads can be smooth or barbed, fixed or free floating, absorbable or non absorbable. Results last several years and extra threads can be added later to compensate for further ageing.
Botulinum toxin injections are used to treat dynamic wrinkles – those formed by repeated muscle contraction from facial expressions such as frown lines, crow’s feet and marionette lines. These injections are also effective for chin creases and the horizontal wrinkles in the lower part of the front of the neck. Patients can return to work straight after treatment and results are seen after around four days. Repeat treatment is necessary after three to five months.
Dermal fillers, biostimulators and fat transfer are used to treat static wrinkles, which are caused by ageing and repetitive muscle movement, and loss of facial volume. The range of dermal fillers available are designed for use near the surface of the skin to treat wrinkles as well as at deeper levels to restore volume. Their duration depends on the mobility of the treated area and the formulation.
Fat transfer is a long-lasting option where the patient’s own fat is harvested, often during a concurrent surgical procedure.
Cosmetic dentistry can correct discoloured, crooked or missing teeth. Veneers and crowns can be used to improve existing teeth, and implants to replace missing teeth. Recovery time is minimal and results can be dramatic, immediate and permanent. Bleaching can also used to whiten discoloured teeth.
Hair reduction laser and intense pulsed light (IPL) treatments treat hair growth on areas such as their chest and back. A laser or light beam targets the follicle of the hair to destroy it at the base. Around six treatments are needed to remove or thin hair. The treatment involves mild discomfort and results are long-term.
Intense pulsed light
Intense pulsed light (IPL) can also be used smooth wrinkles, even skin tone, treat broken capillaries and improve sun damage. It uses multiple wavelengths of light to target specific chromophores (light receptive cells) in the skin. Several treatments are required for satisfactory results. Minimal down time is necessary.
Lasers are also used to treat lines and wrinkles by removing damaged skin and encouraging the production of new cells. Carbon dioxide (CO2) lasers have been used to treat severe scarring but involved serious side effects and extensive recovery time.
Modern laser treatments generally involve only temporary tenderness and redness lasting a few days. Fractionated lasers now include a CO2 laser that can be used on the entire face as well as under the eyes and requires only 10 days to two weeks of down time. acsm